First-in-Human Whole-Abdomen Metabolic Imaging with Hyperpolarized [1-13C]Pyruvate in D2O and Initial Application in Human Pancreatic Cancer

Motivation: Whole-abdomen imaging with hyperpolarized [1-13C]pyruvate holds promise to diagnose metabolic diseases. D2O solvation could extend the 13C T1 lifetime, resulting in enhanced image SNR. Goal(s): Establish the safety and feasibility of utilizing D2O to administer hyperpolarized [1-13C]pyruvate in whole-abdomen imaging, and present the first application of whole-abdomen hyperpolarized [1-13C]pyruvate MRI in a PDAC patient. Approach: We quantified the metabolic characteristics of organs in healthy and diseased subjects. Results: The use of D2O is safe and feasible. It has no significant impact on organ metabolism and delivery of the pyruvate bolus. This technique demonstrates potential for application in cancer patients. Impact: The safety and feasibility of employing D2O for hyperpolarized 13C whole-abdomen MRI sets the stage for translational studies. The first application of hyperpolarized whole-abdomen [1-13C]pyruvate MRI to a PDAC patient provides essential support for its future exploration in oncology.